Injecting Yourself 101

Biologic medications have revolutionized the treatment of psoriasis. They are powerful drugs that can produce dramatic results and, though they carry a slight increased risk of infection, they have very few everyday side effects. For some psoriasis patients, the main downside of biologics is the delivery method: They need to be injected.

Injections can produce pain, bruising, swelling, redness, and itchiness—all of which can be a nuisance for psoriasis patients who need to inject themselves once or twice a week. Patients who are new to biologics may also find themselves confronting a bit of anxiety.

“The first three months were really scary for me,” says Karen, 50, of Milton, Mass., who started taking a biologic in late 2003. “It was the fear of the unknown—and I hated needles. I was a huge needlephobe.” After getting used to the process, Karen was injecting herself twice a week with ease.

Until pharmaceutical companies develop a biologic that is taken orally—and at least one is currently in the pipeline, working its way toward FDA approval—injections are a fact of life for many psoriasis patients. Here’s a guide to making the process as painless and stress-free as possible.

Pick your delivery method
Biologics are available in three formats: a do-it-yourself kit in which the drug has to be mixed and the syringe loaded manually, a prefilled syringe, and a penlike auto-injector. All three are injected under the skin, usually in an area with some fat, such as the stomach, the back of the upper arms, or the legs.

Patients may want to experiment to find out which delivery method is most comfortable for them. Each has its own advantages. The mix-it-yourself version is the most time consuming, but it has a finer needle than the prefilled syringe. The auto-injector is the fastest, but it’s also the hardest to control and is more likely to cause bruising.

Nikki Woistman, 21, of St. Petersburg, Fla., has taken biologics in all three forms. She has never really minded injections—but she does find the auto-injector a bit unnerving. “The anticipation of the shot and pushing the button—it just freaks me out. If I’m injecting myself, I can see when it’s breaking the skin, so I can prepare myself for that initial pain.”

Whatever the method, patients usually take their first dose at a dermatologist’s office, where a nurse walks them through the process. (In some cases, the pharmaceutical companies who manufacture the drugs may provide in-home training.)

“It’s really a pretty simple injection,” says Kathy Kavlick, RN, community outreach nurse for the Murdough Family Center for Psoriasis in Cleveland. “Most people are fine after that first injection and are able to do it on their own at home.”